ROLE OF ASSAYS FOR PARATHYROID-HORMONE-RELATED PROTEIN IN INVESTIGATION OF HYPERCALCEMIA

被引:114
作者
RATCLIFFE, WA
HUTCHESSON, ACJ
BUNDRED, NJ
RATCLIFFE, JG
机构
[1] SELLY OAK HOSP,DEPT CLIN CHEM,BIRMINGHAM,ENGLAND
[2] SELLY OAK HOSP,DEPT SURG,BIRMINGHAM,ENGLAND
关键词
D O I
10.1016/0140-6736(92)90220-W
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Parathyroid-hormone-related protein (PTHrP) has been implicated as a humoral mediator of hypercalcaemia in malignant disease. We have investigated the contributions of PTHrP and parathyroid hormone (PTH) to the hypercalcaemia seen in routine clinical practice by means of highly sensitive immunoradiometric assays. PTHrP concentrations in plasma and PTH concentrations in serum were measured in 121 consecutive patients with hypercalcaemia (corrected serum calcium above 2.65 mmol/l) identified from routine biochemical profiles in a district general hospital. Hypercalcaemia was due to primary hyperparathyroidism in 63 (52%) patients and to malignant disease in 40 (49%). Plasma PTHrP was detectable in 35 (88%) of 40 patients with solid tumours and 3 of 9 patients with haematological malignant disease; it was undetectable in 92% of patients with primary hyperparathyroidism. 7 patients with malignant disease had PTH concentrations above 4.0 pmol/l, consistent with coexisting primary hyperparathyroidism. Measurement of both PTH and PTHrP in all patients led to a change in the diagnosis in 7% of patients. This study provides direct evidence for a humoral role of tumour-derived PTHrP in hypercalcaemia, and shows how PTHrP assays can be used appropriately, in conjunction with PTH assays, to investigate hypercalcaemia in routine clinical practice.
引用
收藏
页码:164 / 167
页数:4
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